Medicaid's precarious future under the GOP

Mike Johnson speaks at a news conference as lawmakers push a budget bill to cut Medicaid

(Image credit: Andrew Harnik / Getty Images)

published 25 February 2025

Republicans "plan to take food and health care away from the poor to subsidize tax cuts for the rich," said Catherine Rampell in The Washington Post. If that sounds "like a stale, Scroogey stereotype," check out the budget blueprint House Republicans unveiled last week. To pay for a $4.5 trillion extension and expansion of President Trump's first-term tax cuts, the plan orders the committee overseeing Medicare and Medicaid to slash spending by $880 billion over 10 years. And since President Trump and House Speaker Mike Johnson have vowed to leave Medicare untouched, Medicaid's annual budget will have to drop by 10 percent. An extra $230 billion in savings is expected from the committee overseeing food stamps. Never mind that 72 million Americans rely on Medicaid and some 40 million receive monthly food assistance. Republicans are desperate to lower their wealthiest backers' tax bills, and if that means "shanking the poor," so be it.

Not all House Republicans are on board, said Meredith Lee Hill in Politico.com. Swing-district members like California Rep. David Valadao, who represents an area where more than 20 percent of residents are on food stamps, worry that slashing safety-net programs "could cost them their seats — and Johnson his razor-thin majority." Then there are GOP members from high-tax blue states who fear "the plan doesn't leave enough room to expand the state and local tax deduction." Thinking those looming fights could derail the House plan, Senate Republicans are pushing ahead with a two-bill strategy, tackling defense and border funding first and then tax cuts later this year. Extending the 2017 tax cuts must take top priority, said The Wall Street Journal in an editorial. Letting those reforms lapse will result in a $4 trillion tax hike next year "that would hit almost every American." If the House proposal can get the votes and avert that calamity, Senate Republicans should back it.

But that plan is no blueprint for fiscal sanity, said Jessica Riedl in The Dispatch. It calls for a $4 trillion extension of the debt ceiling and "would likely add $3.3 trillion to 10-year deficits." It also employs dishonest gimmickry, projecting economic growth "will magically jump above current levels," generating enough tax revenue to cover the cuts. With the national debt above $36 trillion, this smoke-and-mirrors plan invites Democratic attacks painting Republicans as more interested in redistributing wealth upward than fixing runaway federal spending. "Is this really the best they can do?"